NHS Services (Access)

Lilian Greenwood Excerpts

Wednesday 15th October 2014 Commons Chamber

[Andy Burnham]

My hon. Friend is right. We heard the commitment that the Deputy Prime Minister gave last week, and I am sure that he means it, but people will ask why they have not done anything about it in this Parliament. It is lip service. We introduced talking therapies and many other things. The key point is that they cut it faster than they cut the rest of the NHS. Worse still, they introduced a tariff decision this year that will cut it even further and make the problems even worse. It was Labour that proposed parity of esteem between mental and physical health in law. The Government accepted it, but they have done absolutely nothing about it.

[Lilian Greenwood (Nottingham South) (Lab)]

One of the groups most affected by cuts to mental health services is children. On this Government’s watch we have seen increasing numbers of children with mental health difficulties treated on adult psychiatric wards. Is that not completely unacceptable?

[Andy Burnham]

My hon. Friend puts it very well. If mental health is the poor relation of the NHS, then child and adolescent mental health services are the poor relation of the poor relation. How can that be the case when we are talking about children who need the best possible support—the most vulnerable children—being denied the services that they need? My hon. Friend the Member for Leicester West (Liz Kendall) discussed at a shadow health team meeting a constituency case where a family were trying to find a bed for a child who was in a crisis and not one bed was available for that child in the whole country—not one bed. She is nodding. That is the reality. I wish that Government Members would focus on that rather than making complacent statements.

No amount of spin from the Government can disguise the fact that the NHS is heading for the rocks and urgently needs turning around, so the question is how we get it back on track. I have two positive proposals to put before the House on policy direction and on funding. Let me take each in turn. Instead of just admitting privately that the reorganisation was a mistake, the Government should be actively working with us to begin to put it right—and they will soon have a chance to do so. In five weeks, my hon. Friend the Member for Eltham (Clive Efford) will bring a Bill before this House to repeal the worst aspects of the Health and Social Care Act 2012. When the Government’s reorganisation was going through, their mantra was “Doctors will decide.” The Prime Minister repeated this in his “Today” programme interview during the Conservative party conference when he said:

“there’s nothing we’ve done which makes it more likely there’ll be private provision in the NHS”.

--- Later in debate ---

[Mr Hunt]

The right hon. Gentleman is quite wrong. My right hon. Friend said that there was a list of three providers, all with private provision involved. When the right hon. Gentleman was Health Secretary, he accepted that all-private shortlist for the Hinchingbrooke decision. In other words, the biggest privatisation in NHS history happened because of a decision taken by the shadow Health Secretary.

Government Members are not ideological. We believe there are times when we can learn from the independent sector, but, normally, people use the private sector when they are looking for innovation or better value. Only a Labour Government would sign deals with the private sector, paying 11% more than the NHS rate, and ending up paying more than £200 million for operations that never happened. What a shocking waste of money. When the right hon. Gentleman next talks about privatisation, instead of inventing a privatisation agenda that does not exist, will he apologise for a botched one that existed when Labour was in office?

Finally, there is a comparison that Labour never wants to make when talking about NHS performance: what happens over the border in Wales. That is where the policies that the right hon. Gentleman supports are put into practice. Let us see the difference. A record one in every seven Welsh people find themselves sitting on an NHS waiting list, compared with just one in 17 people in England. The urgent cancer waiting time target has not been met once since 2008 in Wales, but it has been missed in England in only two quarters in the whole period. A and E waiting times have been met every year in England, but they have not been met since 2008 in Wales.

[Lilian Greenwood]

Will the Secretary of State give way?

[Mr Hunt]

No, I will finish this point.

The British Medical Association, no friend of the Conservative party, described the NHS in Wales as being in a state of imminent meltdown. The point is that the NHS in England, like the NHS in Wales, faces huge pressure, but politicising operational problems in England, while denying much greater failings in Wales, is the worst kind of opportunism. For Labour Members, good headlines for Labour matter more than poor care on Labour’s watch. They are playing politics with our NHS. That not only scares people in England, but betrays people in Wales.

I shall conclude—

[Lilian Greenwood]

Will the Secretary of State give way?

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. The right hon. Gentleman is not giving way. He must be allowed to speak.

--- Later in debate ---

[Lilian Greenwood (Nottingham South) (Lab)]

Earlier today, my hon. Friend the Member for Darlington (Jenny Chapman) asked the Prime Minister about the mothers from her constituency who marched 300 miles this summer to show their anger at this Government’s wasteful mismanagement of the health service. He dodged her question of course, because he has no answer to it. Is it reassuring that members of the Cabinet have finally realised what the rest of us have known for four years—that reorganising the NHS was a big mistake? I do not think so. There is disgust and anger out there, but not surprise. I was proud to walk alongside the Darlo Mums when their long march passed through Nottingham. The T-shirt I wore that day has a slogan on it. Sadly, I am not allowed to wear it here. It says, “Never trust a Tory with your NHS”. That is good advice.

We all remember what the Prime Minister promised before the election—no more top-down reorganisations. That promise did not last long. The reason I am angry is not just because that was not true, but because the reorganisation was the wrong policy at the worst possible time. We know that the finances are difficult. With both an ageing population and increasingly complex and expensive treatments available, the NHS faces unprecedented challenges. But instead of focusing on achieving the best possible outcomes for people with the resources available, the Prime Minister caused chaos: 4,000 staff were laid off and rehired; nurse numbers have not kept pace with demand; training places were cut; there are not enough GPs; training has been scaled back; hospitals are tied up in competition law; and savage cuts have been made to local authorities, leading to a crisis in social care and so pushing more and more elderly people into A and E when they should be getting the care they need at home. It is no wonder that morale is low when half of nurses say that their wards are dangerously understaffed; Ministers undermine the independent pay review body; and managers are being rehired after having six-figure pay-offs. But what makes me really angry is the impact that this wasteful reorganisation has had on my own constituents. I am proud of the NHS in Nottingham—whether in primary care, mental health services or our two acute hospitals. I know that we have great staff working incredibly hard for the people who need them, but at every level they face unbelievable pressure, and, in places, they are really struggling to cope.

The chief executive of Nottingham University Hospitals NHS Trust was very blunt when he met local MPs a couple of weeks ago. He told us that the trust faces the toughest ever cost-reduction plan, that this year he is planning for a deficit of £19.1 million—the first time the trust has been in that position—and that targets are being missed.

The accident and emergency department at Queen’s has missed the four-hour waiting target every month since August last year, and it reached its worst performance this June, in the middle of summer. I know our local hospital is planning for winter, but the crisis is already here. The reasons for the crisis are not simple, but it is clear that patient flow, both through and out of the hospital, is creating particular problems. Hundreds of patients who are well enough to be discharged or who should be receiving care and support at home or in residential care are still in hospital because their discharge is delayed. That is because, despite a commitment to joint working, social services cannot cope. The deep cuts to social care are having a real and direct impact on the NHS in Nottinghamshire and on my constituents.

NHS privatisation is now taking hold as commissioners are forced to put services out to the market. Let me tell the House about patient transport and my constituent, Jean. Jean is 84 years old and very unwell. She needs four hours of dialysis three times a week. Since a private company took over patient transport, she has been late for appointments, and had to wait for hours to be taken home. Such poor service has a knock-on impact on other patients in our city’s hospitals and the clinical commissioning group tells me that Jean’s experience is typical of feedback from other patients.

Last week, the chair of the hospitals trust described meeting a patient at 10 o’clock at night. That patient had been waiting since 10 o’clock in the morning to go home where his wife was waiting for him. Patients deserve so much better. Next May, they will have a chance to vote on the service, because Labour has a plan for the NHS. We will raise £2.5 billion for an NHS “time to care” fund. The money will come not from ordinary working people, but from ensuring that hedge funds and other tax avoiders play by the rules, and from asking those at the top to pay more and introducing fees on tobacco companies. The £2.5 billion will be used to employ enough doctors and nurses with the time to care for patients—20,000 more nurses to ensure that we get the basics right with safe staffing; 8,000 more GPs to help people stay healthy outside hospital; and 5,000 new home care workers and 3,000 more midwives. We will ensure better access and guarantee GP appointments in 48 hours or on the same day for those who need it. We will repeal the Tories’ NHS changes that put private profit before patients, so that our health service does the things that it should, such as care for patients and not argue about competition law. We will give patients and the public a real say over local services, and bring together physical health, mental health and social care into a single service to meet all of a person’s care needs —whole person care.

The message from the Darlo Mums to the Government was clear: hands off our NHS. It might not fit on a T-shirt, but my message today is equally clear. Labour built the NHS, Labour will save the NHS, and only Labour can transform it for the future.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

It is a pleasure to conclude this debate and to speak to the contributions of hon. Friends and hon. Members. It is a pity that when we have NHS debates, they sometimes become unnecessarily tribal and partisan. Some Labour Members often seek to talk down the local NHS rather than to stand up for their hard-working NHS staff who deliver high-quality services on the ground.

I want to talk about some of the successes this Government have delivered for our NHS and then I shall address some of the points raised in the debate. We know that even in these difficult economic times, this Government have protected our NHS budget with £12.7 billion more during this Parliament. That was something that the shadow Secretary of State, the right hon. Member for Leigh (Andy Burnham) called “irresponsible”, but it is not irresponsible to make sure that we continue to support and protect the NHS front line. We have stripped out over £5 billion-worth of bureaucracy and reinvested that money into front-line patient care. That has been audited by the National Audit Office, but the hon. Member for Leicester West (Liz Kendall) did not choose to highlight that point in her remarks. It has been confirmed and we know it is true.

I make no apology for the fact that we as a Government have focused ruthlessly on having a more efficient health service that frees up as much money as possible for front-line patient care. We have reduced the number of administrative staff by around 20,000, increased front-line clinical staff by over 12,500 and set up a cancer drugs fund that has helped 55,000 people who would not have received cancer drugs to receive them. There has been an unrelenting focus on promoting a more joined-up approach to care, to help deliver more care in the community for people with long-term medical conditions, particularly the frail elderly.

Let me deal with some of the comments and contributions to the debate. I would like to reassure my hon. Friend the Member for Morecambe and Lunesdale (David Morris) that the hospital in his constituency is, of course, not going to close and that any local scaremongering by the Labour party is wrong and misplaced. I would also like to reassure the hon. Member for North Durham (Mr Jones), who raised concerns about the north-east ambulance service, that the service has generally been performing well. In 2013-14, it met all its national targets. I urge the hon. Gentleman to write to me if he has any further concerns on behalf of local patients.

We heard strong contributions from my hon. Friend the Member for Norwich North (Chloe Smith), who made important remarks about the services delivered at the Norfolk and Norwich hospital, and I look forward to accepting her invitation to visit that hospital once again in the near future, and from my hon. Friend the Member for Bosworth (David Tredinnick) who made one of his regular pleas for more alternative medicine in the NHS. Importantly, he talked about the benefits of clinically driven commissioning. Under this Government, we have put doctors and nurses in charge of our NHS to make sure that services are delivered at local level. Patient services are run by doctors and nurses, not by bureaucrats, which has been a tremendous step forward. My hon. Friend the Member for St Ives (Andrew George) made a considered contribution about the previous Government’s record on encouraging private sector providers in the NHS—a point to which I shall return.

[Lilian Greenwood]

What does the Minister think about what happened to the clinical commissioning group in North Staffordshire, which decided not to allow people with mild to moderate hearing loss to have hearing aids, even though that was clearly not the view of the local health scrutiny committees or local patients? Is that not precisely putting in jeopardy preventive services, which would keep people in work and keep them active in the community rather than being isolated? It is stopping those people from participating.

[Dr Poulter]

If the hon. Lady has concerns about local commissioning decisions, she should take them up with local commissioners. Time forbids me from going into the rationing of services by the previous Labour Government. It is important that clinical services are now designed and delivered by front-line health care professionals, and if she is concerned about them, I am sure she will take that up with her local CCG.

The right hon. Member for Leigh (Andy Burnham) referred to a work force crisis in GP training. It is clear that under this Government 1,000 more GPs are now in training and working in the NHS than in 2010 when we came into government. If it is not accepted that that is good start, we have committed to training an extra 5,000 because we want more people working in general practice.

We have ensured that 1.3 million more people are being treated in A and E compared with the number in 2009-10. We have halved the time that people must wait to be assessed, and every day we are treating nearly 2,000 more people within the four-hour target compared with the number in 2010.

Competition was introduced into the NHS not by the Health and Social Care Act 2012 but by the previous Labour Government, of whom the right hon. Member for Leigh was a Minister. The Labour Government opened the door to private sector providers when they opened the first independent sector treatment centres in 2003. The Labour Government gave £250 million to private companies and independent sector treatment centres, regardless of whether they delivered that care. Labour was more concerned about giving money to the private centres than about ensuring that quality care was delivered. Labour paid independent private sector providers 11% more to provide the same care as NHS providers. That is Labour’s record on the private sector in the NHS—a record that shows that it is more committed to the private sector than any previous Conservative Government.